Organization
OGLALA LAKOTA AIR RESCUE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WADE ALBERT BLACK (CEO)
(214) 592-2627
Entity
Organization
Contact information
Practice address
12 AIRPORT RD, PINE RIDGE, SD 57770-3072
(805) 242-4048
Mailing address
4211 W INTERSTATE 40 STE 200, AMARILLO, TX 79106-6053
(806) 322-4448
Taxonomy
Speciality
Code
Description
License number
State
3416A0800X
Air Ambulance
Primary
—
—
Other
Enumeration date
10/28/2019
Last updated
10/28/2019
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